ENDOCRINE
HYPOGLYCAEMIA
PromptCauses of hypoglycaemia
ResponseExPLAIN
Exogenous drugs (Insulin, sulphonylurea, others)
Pancreatitis/Pituitary
Liver disease
Alcohol, Addisons
Insulinoma
Non pancreatic neoplasm
Exogenous drugs (Insulin, sulphonylurea, others)
Pancreatitis/Pituitary
Liver disease
Alcohol, Addisons
Insulinoma
Non pancreatic neoplasm
PromptManagement hypoglycemia
ResponseGlucose 50% 25 mL OR 2.5mL/kg 10% dextrose
Glucagon 0.5-2mg IM (won’t work in liver failure)
Octreotide 50 mics IV + infusion in sulfonylurea overdose
Glucagon 0.5-2mg IM (won’t work in liver failure)
Octreotide 50 mics IV + infusion in sulfonylurea overdose
- Tox phone call 50 mics S/C QID to avoid infusion but not sure if this is written anywhere
PromptTHYROID
Response
PromptHYPERTHYROID
Response
PromptSymptoms of thyrotoxicosis
ResponseHyperthyroid hits fast forward button on everything! Name something then make it faster
Neuropsychiatric - anxiety, restlessness, agitation
CVS - Dyspnoea, palpitations
Metabolic - weight loss, increased appetite
Neuromuscular - tremor/shakes
Cutaneous - Diaphoresis, heat intolerance
GIT - Hyper Stooling
Neuropsychiatric - anxiety, restlessness, agitation
CVS - Dyspnoea, palpitations
Metabolic - weight loss, increased appetite
Neuromuscular - tremor/shakes
Cutaneous - Diaphoresis, heat intolerance
GIT - Hyper Stooling
PromptExamination findings in hyperthyroidism
ResponseCutaneous - Pretibial myxoedema (Peau De Orange anterior shins), thyroid acropachy (Clubbing + oedema of hands), onycholysis (Nail separated from underlying skin)
CVS - tremo/tachycardia
Neurologic - hyperreflexia
Occular - exopthalmus
Thyroid - tender, enlarged gland, focal pathology (nodule/tumour)
CVS - tremo/tachycardia
Neurologic - hyperreflexia
Occular - exopthalmus
Thyroid - tender, enlarged gland, focal pathology (nodule/tumour)
PromptDescribe Pemberton's Sign (My grandfathers middle name)
ResponseTriad on lifting arms above the head
- Facial congestion
- Cyanosis
- Respiratory distress
PromptCauses of hyperthyroidism
ResponseGraves - eye signs eg: exopthalmos
Thyroiditis - (radiation/post partum) tender enlarged thyroid gland
Toxic multinodular goitre - Large thyroid gland, irregular, lots of nodules
Toxic adenoma - unilateral lump in thyroid
Drug induced - Lithium, Amiodarone
Central hyperthyroidism - Pituitary adenoma, ectopic thyroid tissue
Thyroiditis - (radiation/post partum) tender enlarged thyroid gland
Toxic multinodular goitre - Large thyroid gland, irregular, lots of nodules
Toxic adenoma - unilateral lump in thyroid
Drug induced - Lithium, Amiodarone
Central hyperthyroidism - Pituitary adenoma, ectopic thyroid tissue
PromptBloods to differentiate primary vs secondary hyperthyroidism
ResponseT4 will be high in both
TSH low in primary, but high TSH in secondary (cause is thyroid being told to make too much thyroid hormone, not the thyroid itself)
TSH low in primary, but high TSH in secondary (cause is thyroid being told to make too much thyroid hormone, not the thyroid itself)